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Protocol - Baseline and Trauma Challenge Physiology

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Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Description:

The Baseline and Trauma Challenge Psychophysiological Recordings protocol consists of a Baseline phase and a Trauma Challenge (trauma interview and trauma imagery) phase. During the baseline phase, skin conductance and heart rate are monitored continuously for 5 minutes while the participant rests quietly without talking. During the first part of the Trauma Challenge, heart rate and skin conductance are continuously measured while the participant is administered a 21-question, open-ended trauma interview. After the interview, skin conductance and heart rate are monitored continuously for 60 seconds while the participant is asked to think about and imagine the traumatic event.

Derived scores include average skin conductance and heart rate calculated for baseline, trauma interview, and trauma imagery as well as the difference in heart rate and skin conductance between (1) trauma interview and baseline, (2) trauma imagery and baseline, and (3-5) the first and last minutes within each measurement period (baseline, trauma interview, and trauma imagery).

Protocol:

BASELINE AND TRAUMA CHALLENGE PSYCHOPHYSIOLOGICAL RECORDINGS PROTOCOL

Have the individual sit comfortably in a chair.

Skin conductance (SC): Any device that records continuously at a rate of 5 samples per second or higher. Add isotonic paste to metal part of electrodes and attach them to fingers.

Heart rate (HR): Any device that records continuously at a rate of 20 samples per second or higher. Attach to finger (devices such as pulse oximeters) or wrist (for watch devices).

Once device is attached, verify that data is being recorded (either by visual or numerical representation of the data).

BASELINE

Ask individual to rest quietly without talking for 5 minutes. Record SC and HR continuously for 5 minutes. Mark the end of the 5-minute period or stop and save the data as "Baseline."

TRAUMA INTERVIEW (Adapted from Standardized Trauma Interview, Foa & Rothbaum, 1998)

Start recording data and ask the following questions:

1. Please briefly describe the event that happened to you

2. What time of day did it happen?

3. Where did it happen?

4. How long did this event last? That is, how long was it from the moment you first felt like you were in danger until you felt safe again?

5. How long ago did it happen?

6. How much have you slept since it happened?

7. What is your relationship with the perpetrator (if applicable)?

8. Was anyone under the influence of drugs or alcohol when it happened?

9. Was anyone else with you?

10. Did you have any injuries? What were they?

11. Do you anticipate long-term physical problems as a result of this event?

12. Was anyone else injured?

13. Was anyone killed?

14. Did you see other people’s injury or death?

15. At the time of the incident, did you think you would be seriously injured or killed?

16. During the event, how helpless did you feel?

17. During the event, how horrified or shocked did you feel?

18. During the event, how terrified or afraid did you feel?

19. During the event, how much control did you feel?

20. Have you ever experienced a similar event before?

21. How many times?

Mark the end of the interview of stop and save the data as "Trauma interview"

TRAUMA IMAGERY

Start recording data and ask the participant to think about and imagine the traumatic event. Record SC and HR continuously for 60 seconds. Mark the end of the 1-minute period or stop and save the data as "Trauma imagery."

DATA SCORING:

Calculate average SC for 5-minute Baseline, Trauma interview, and Trauma imagery. Calculate the difference between Trauma interview and Baseline, and Trauma imagery and Baseline. Calculate average SC for first minute and last minute of each phase. Note duration of Trauma interview. Calculate change score from first to last minute within each phase (correct Trauma interview by duration). Repeat with HR data.

There will be a total of 9 variables for each measure:

1. Baseline average

2. Trauma interview average

3. Trauma imagery average

4. Difference between Baseline and Trauma interview averages

5. Difference between Baseline and Trauma imagery averages

6. Change from first to last minute of Baseline

7. Change from first to last minute of Trauma interview

8. Change from first to last minute of Trauma imagery

Change from first to last minute of Trauma interview divided by interview duration

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population and to respond appropriately to emotional distress that can be elicited by trauma interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Research technicians must be trained in the proper administration and placement of the skin conductance and heart-rate monitors.

Equipment Needs

Skin conductance (SC): Any device that records continuously at a rate of 5 samples per second or higher that can export data for analysis. Add isotonic paste to metal part of electrodes, and attach them to fingers.

Heart rate (HR): Any device that records continuously at a rate of 20 samples per second or higher that can export data for analysis. Attach to finger (devices such as pulse oximeters) or wrist (for watch devices).

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

This protocol combines the Standardized Trauma Interview (STI) developed by Foa & Rothbaum (1998) with the procedure for recording skin conductance and heart rate during trauma script imagery developed by Pitman et al. (1987). The procedure included in Pitman et al. (1987) utilizes participant-specific scripts that were developed during a prior interview and then read during the trauma challenge. This process for developing the trauma-script is not standardized and does not meet the PhenX criteria for low burden protocols. Both of these issues are resolved by instead using the STI for trauma script imagery.

Research Domain Information

Release Date:

November 21, 2014

Definition

A psychophysiological test to measure changes in skin conductance and heart rate in response to a trauma interview and trauma imagery.

Purpose

Post-traumatic stress disorder (PTSD) is associated with excessive autonomic nervous system arousal and physiological reactivity to trauma-related cues long after the occurrence of the traumatic event. Quantification of this reactivity has potential relevance to individual differences in physical and mental health outcomes that include medical conditions and response to PTSD treatment.

Selection Rationale

The Baseline and Trauma Challenge Psychophysiological Recordings protocol is a widely used, valid, and reliable objective measure of emotion-related biological arousal.

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Trauma interview psychophysiological test Score4588716CDE Browser

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford Press.

Pitman, R. K., Orr, S. P., Forgue, D. F., de Jong, J. B., & Claiborn, J. M. (1987). Psychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans. Archives of General Psychiatry, 44(11), 970-975.

General References

Blechert, J., Michael, T., Grossman, P., Lajtman, M., & Wilhelm, F. H. (2007). Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder. Psychosomatic Medicine, 69(9), 935-943.

Bryant, R. A. (2006). Longitudinal psychophysiological studies of heart rate: Mediating effects and implications for treatment. Annals of the New York Academy of Sciences, 1071, 19-26.

Buckley, T. C., & Kaloupek, D. G. (2001). A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosomatic Medicine, 63(4), 585-594.

Keane, T. M., Kolb, L. C., Kaloupek, D. G., Orr, S. P., Blanchard, E. B., Thomas, R. G., Hsieh, F. Y., & Lavori, P. W. (1998). Utility of psychophysiological measurement in the diagnosis of posttraumatic stress disorder: Results from a Department of Veterans Affairs Cooperative Study. Journal of Consulting and Clinical Psychology 66(6), 914-923.

Jovanovic, T., Norrholm, S. D., Sakoman, A. J., Esterajher, S., & Kozarić-Kovacić, D. (2009). Altered resting psychophysiology and startle response in Croatian combat veterans with PTSD. International Journal of Psychophysiology, 71(3), 264-268.

McTeague, L. M., Lang, P. J., Laplante, M. C., Cuthbert, B. N., Shumen, J. R., & Bradley, M. M. (2010). Aversive imagery in posttraumatic stress disorder: Trauma recurrence, comorbidity, and physiological reactivity. Biological Psychiatry, 67(4), 346-356.

Orr, S. P., Meyerhoff, J. L., Edwards, J. V., & Pitman, R. K. (1998). Heart rate and blood pressure resting levels and responses to generic stressors in Vietnam veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 155-164.

Pineles, S. L., Mostoufi, S. M., Ready, C. B., Street, A. E., Griffin, M. G., & Resick, P. A. (2011). Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship? Journal of Abnormal Psychology, 120(1), 240-246.

Pineles, S. L., Suvak, M. K., Liverant, G. I., Gregor, K., Wisco, B. E., Pitman, R. K., & Orr, S. P. (2013). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychiatry, 122(3), 635-644.

Pole, N., Neylan, T. C., Otte, C., Metzler, T. J., Best, S. R., Henn-Haase, C., & Marmar, C. R. (2007). Associations between childhood trauma and emotion-modulated psychophysiological responses to startling sounds: A study of police cadets. Journal of Abnormal Psychology, 116(2), 352-361.

Shalev, A. Y., Peri, T., Brandes, D., Freedman, S., Orr, S. P., & Pitman, R. K. (2000). Auditory startle response in trauma survivors with posttraumatic stress disorder: A prospective study. American Journal of Psychiatry, 157(2), 255261.

Zatzick, D. F., Grossman, D. C., Russo, J., Pynoos, R., Berliner, L., Jurkovich, G., Sabin, J. A., Katon, W., Ghesquiere, A., McCauley, E., & Rivara, F. P. (2006). Predicting posttraumatic stress symptoms longitudinally in a representative sample of hospitalized injured adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 45(10), 1188-1195.

Protocol ID:

630901

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX630901_Average_SkinConductance_BaselinePX630901010000Average Skin Conductance for 5-minute Baseline4N/A
PX630901_Average_SkinConductance_TraumaInterviewPX630901020000Average Skin Conductance for Trauma interview4N/A
PX630901_Average_SkinConductance_TraumaImageryPX630901030000average Skin Conductance for Trauma imagery4N/A
PX630901_Difference_SkinConductance_Baseline_TraumaInterviewPX630901040000Difference of Skin Conductance between Baseline and Trauma interview averages4N/A
PX630901_Difference_SkinConductance_Baseline_TraumaImageryPX630901050000Difference of Skin Conductance between Baseline and Trauma imagery averages4N/A
PX630901_Change_SkinConductance_Baseline_FirstToLast_MinutePX630901060000Change of Skin Conductance from first to last minute of Baseline4N/A
PX630901_Change_SkinConductance_TraumaInterview_FirstToLast_MinutePX630901070000Change of Skin Conductance from first to last minute of Trauma interview4N/A
PX630901_Change_SkinConductance_TraumaImagery_FirstToLast_MinutePX630901080000Change of Skin Conductance from first to last minute of Trauma imagery4N/A
PX630901_Change_SkinConductance_TraumaInterview_Over_DurationPX630901090000Change of Skin Conductance from first to last minute of Trauma interview divided by interview duration4N/A
PX630901_Average_HeartRate_BaselinePX630901100000Average Heart Rate for 5-minute Baseline4N/A
PX630901_Average_HeartRate_TraumaInterviewPX630901110000Average Heart Rate for Trauma interview4N/A
PX630901_Average_HeartRate_TraumaImageryPX630901120000average Heart Rate for Trauma imagery4N/A
PX630901_Difference_HeartRate_Baseline_TraumaInterviewPX630901130000Difference of Heart Rate between Baseline and Trauma interview averages4N/A
PX630901_Difference_HeartRate_Baseline_TraumaImageryPX630901140000Difference of Heart Rate between Baseline and Trauma imagery averages4N/A
PX630901_Change_HeartRate_Baseline_FirstToLast_MinutePX630901150000Change of Heart Rate from first to last minute of Baseline4N/A
PX630901_Change_HeartRate_TraumaInterview_FirstToLast_MinutePX630901160000Change of Heart Rate from first to last minute of Trauma interview4N/A
PX630901_Change_HeartRate_TraumaImagery_FirstToLast_MinutePX630901170000Change of Heart Rate from first to last minute of Trauma imagery4N/A
PX630901_Change_HeartRate_TraumaInterview_Over_DurationPX630901180000Change of Heart Rate from first to last minute of Trauma interview divided by interview duration4N/A